Objectives We examined undergraduate STEM students’ experiences during Spring 2020 when universities switched to remote instruction due to the COVID-19 pandemic. Specifically, we sought to understand actions by universities and instructors that students found effective or ineffective, as well as instructor behaviors that conveyed a sense of caring or not caring about their students’ success. Methods In July 2020 we conducted 16 focus groups with STEM undergraduate students enrolled in US colleges and universities (N = 59). Focus groups were stratified by gender, race/ethnicity, and socioeconomic status. Content analyses were performed using a data-driven inductive approach. Results Participants (N = 59; 51% female) were racially/ethnically diverse (76% race/ethnicity other than non-Hispanic white) and from 32 colleges and universities. The most common effective instructor strategies mentioned included hybrid instruction (35%) and use of multiple tools for learning and student engagement (27%). The most common ineffective strategies mentioned were increasing the course workload or difficulty level (18%) and use of pre-recorded lectures (15%). The most common behaviors cited as making students feel the instructor cared about their success were exhibiting leniency and/or flexibility regarding course policies or assessments (29%) and being responsive and accessible to students (25%). The most common behaviors cited as conveying the instructors did not care included poor communication skills (28%) and increasing the difficulty of the course (15%). University actions students found helpful included flexible policies (41%) and moving key services online (e.g., tutoring, counseling; 24%). Students felt universities should have created policies for faculty and departments to increase consistency (26%) and ensured communication strategies were honest, prompt, and transparent (23%). Conclusions To be prepared for future emergencies, universities should devise evidence-based policies for remote operations and all instructors should be trained in best practices for remote instruction. Research is needed to identify and ameliorate negative impacts of the pandemic on STEM education.

Background Although calorie tracking is one of the strongest predictors of weight loss in behavioral weight loss interventions, low rates of adherence are common. Objective This study aims to examine the feasibility and acceptability of using the Slip Buddy app during a 12-week web-based weight loss program. Methods We conducted a randomized pilot trial to evaluate the feasibility and acceptability of using the Slip Buddy app compared with a popular commercial calorie tracking app during a counselor-led, web-based behavioral weight loss intervention. Adults who were overweight or obese were recruited on the web and randomized into a 12-week web-based weight loss intervention that included either the Slip Buddy app or a commercial calorie tracking app. Feasibility outcomes included retention, app use, usability, slips reported, and contextual factors reported at slips. Acceptability outcomes included ratings of how helpful, tedious, taxing, time consuming, and burdensome using the assigned app was. We described weight change from baseline to 12 weeks in both groups as an exploratory outcome. Participants using the Slip Buddy app provided feedback on how to improve it during the postintervention focus groups. Results A total of 75% (48/64) of the participants were female and, on average, 39.8 (SD 11.0) years old with a mean BMI of 34.2 (SD 4.9) kg/m2. Retention was high in both conditions, with 97% (31/32) retained in the Slip Buddy condition and 94% (30/32) retained in the calorie tracking condition. On average, participants used the Slip Buddy app on 53.8% (SD 31.3%) of days, which was not significantly different from those using the calorie tracking app (mean 57.5%, SD 28.4% of days), and participants who recorded slips (30/32, 94%) logged on average 17.9 (SD 14.4) slips in 12 weeks. The most common slips occurred during snack times (220/538, 40.9%). Slips most often occurred at home (297/538, 55.2%), while working (153/538, 28.4%), while socializing (130/538, 24.2%), or during screen time (123/538, 22.9%). The conditions did not differ in participants’ ratings of how their assigned app was tedious, taxing, or time consuming (all values of P>.05), but the calorie tracking condition gave their app higher helpfulness and usability ratings (all values of P<.05). Technical issues were the most common type of negative feedback, whereas simplicity was the most common type of positive feedback. Weight losses of ≥5% of baseline weight were achieved by 31% (10/32) of Slip Buddy participants and 34% (11/32) of calorie tracking participants. Conclusions Self-monitoring of dietary lapses and the contextual factors associated with them may be an alternative for people who do not prefer calorie tracking. Future research should examine patient characteristics associated with adherence to different forms of dietary self-monitoring. Trial Registration ClinicalTrials.gov NCT02615171; https://clinicaltrials.gov/ct2/show/NCT02615171

Background Behavioral weight loss programs typically enroll 12-40 people into groups that then suffer from declining engagement over time. Web-based patient communities, on the other hand, typically offer no limits on capacity and membership is fluid. This model may be useful for boosting engagement in behavioral weight loss interventions, which could lead to better outcomes. Objective In this study, we aimed to examine the feasibility and acceptability of continuously enrolling participants into a Facebook-delivered weight loss intervention for the first 8 of 16 weeks relative to the same intervention where no new participants were enrolled after randomization. Methods We conducted a randomized pilot trial to compare a Facebook weight loss group that used open enrollment with a group that used closed enrollment on feasibility and acceptability in adults with BMI 27-45 kg/m2. The feasibility outcomes included retention, engagement, and diet tracking adherence. We described the percentage loss of ≥5% weight in both groups as an exploratory outcome. We also explored the relationship between total volume of activity in the group and weight loss. The participants provided feedback via web-based surveys and focus groups. Results Randomized participants (68/80, 85% women) were on average, aged 40.2 (SD 11.2) years with a mean BMI of 34.4 (SD 4.98) kg/m2. We enrolled an additional 54 participants (50/54, 93% female) in the open enrollment condition between weeks 1 and 8, resulting in a total group size of 94. Retention was 88% and 98% under the open and closed conditions, respectively. Randomized participants across conditions did not differ in engagement (P=.72), or diet tracking adherence (P=.42). Participant feedback in both conditions revealed that sense of community was what they liked most about the program and not enough individualized feedback was what they liked the least. Weight loss of ≥5% was achieved by 30% (12/40) of the participants randomized to the open enrollment condition and 18% (7/40) of the participants in the closed enrollment condition. Exploratory analyses revealed that the open condition (median 385, IQR 228-536.5) had a greater volume of engagement than the closed condition (median 215, IQR 145.5-292; P=.007). Furthermore, an increase of 100 in the total volume of engagement in the Facebook group each week was associated with an additional 0.1% weekly weight loss among the randomized participants (P=.02), which was independent of time, individual participant engagement, and sociodemographic characteristics. Conclusions Open enrollment was as feasible and acceptable as closed enrollment. A greater volume of engagement in the Facebook group was associated with weight loss, suggesting that larger groups that produce more engagement overall may be beneficial. Future research should examine the efficacy of the open enrollment approach for weight loss in a fully powered randomized trial. Trial Registration ClinicalTrials.gov NCT02656680; https://clinicaltrials.gov/ct2/show/NCT02656680

ObjectiveExperiences and internalization of weight stigma are associated with greater self‐reported psychological distress and symptoms of psychiatric disorders such as depression and anxiety. However, little is known about the extent to which individuals who have experienced and internalized weight stigma are diagnosed with or provided treatment for psychiatric conditions. The current study aimed to characterize the prevalence of diagnosed psychiatric disorders among adults with obesity who had experienced and internalized weight stigma.MethodsWeight‐loss treatment‐seeking adults with a history of experiencing weight stigma and high levels of internalized weight stigma were recruited for two clinical trials.ResultsIn Study 1 (n = 84, 83.3% women, 67.9% Black), 25% of participants reported a lifetime history of a mood disorder. Few participants (<10%) reported current psychiatric diagnoses or use of psychiatric medications. In Study 2 (n = 129, 88.4% women, 65.1% white), one‐third of participants reported a mood disorder history, and 21.7% reported an anxiety disorder history, with approximately 16%–18% reporting current diagnoses. In both studies, few participants reported a history of a diagnosed eating disorder despite high rates of current full‐ or subthreshold symptoms. Based on Beck Depression Inventory‐II scores, approximately 54%–64% of participants reported mild or greater symptoms of depression.ConclusionsOverall, lifetime history of diagnosed psychiatric disorders and current symptoms of depression and eating disorders were relatively high across two samples. More research is needed to determine the impact of weight stigma on the diagnosis and treatment of eating disorders and other psychiatric concerns.

Background Melanoma is the second most common cancer in young adults. Social media may be a means to conduct interventions to increase sun safety in young adults. Purpose We conducted a randomized proof-of-concept pilot trial to evaluate the feasibility and acceptability of a dissonance-based social media intervention designed to promote sun safety in young adult tanners. Methods Young adult tanners (N = 66) were randomized into two 4-week interventions in which participants were incentivized to create content for a social media campaign on healthy skin or healthy lifestyle. Feasibility outcomes included retention, participation, acceptability, and contamination. We also examined the impact of participation on motivation to engage in the target health behaviors and outdoor tanning intentions. Results Retention was 100%. Most Healthy Skin (88%) and Healthy Lifestyle participants (91%) created ≥1 post. Acceptability was high with 94% and 97% of participants in Healthy Skin and Healthy Lifestyle conditions, respectively, agreeing they would recommend the campaign to a friend. At 4 weeks, Healthy Skin participants reported greater declines in motivation to tan indoors (p = .0017) and outdoors (p = .0003), and greater increases in motivation to wear sunscreen (p = .0009) and protective clothing (p = .0342). Healthy Skin participants reported greater declines in intentions to tan outdoors in the next year (p = .0286). Conclusions A dissonance-based, social media sun safety intervention was feasible and acceptable. Future research should examine the efficacy and longer-term effects of this intervention in young adults at elevated risk for skin cancer. Trial Registration Clinicaltrials.gov NCT03834974 https://clinicaltrials.gov/ct2/show/NCT03834974